Samsung Medical Center, Seoul, Korea.
Oncology Research & Development, Pfizer, San Diego, CA, USA.
Nat Commun. 2020 Dec 2;11(1):6175. doi: 10.1038/s41467-020-19933-0.
To elucidate the effects of neoadjuvant chemotherapy (NAC), we conduct whole transcriptome profiling coupled with histopathology analyses of a longitudinal breast cancer cohort of 146 patients including 110 pairs of serial tumor biopsies collected before treatment, after the first cycle of treatment and at the time of surgery. Here, we show that cytotoxic chemotherapies induce dynamic changes in the tumor immune microenvironment that vary by subtype and pathologic response. Just one cycle of treatment induces an immune stimulatory microenvironment harboring more tumor infiltrating lymphocytes (TILs) and up-regulation of inflammatory signatures predictive of response to anti-PD1 therapies while residual tumors are immune suppressed at end-of-treatment compared to the baseline. Increases in TILs and CD8+ T cell proportions in response to NAC are independently associated with pathologic complete response. Further, on-treatment immune response is more predictive of treatment outcome than immune features in paired baseline samples although these are strongly correlated.
为了阐明新辅助化疗(NAC)的效果,我们对 146 例乳腺癌患者的纵向队列进行了全转录组分析,并结合组织病理学分析,其中包括 110 对在治疗前、第一周期治疗后和手术时收集的连续肿瘤活检。在这里,我们表明细胞毒性化疗会引起肿瘤免疫微环境的动态变化,这些变化因亚型和病理反应而异。仅仅一个周期的治疗就会诱导出一个具有更多肿瘤浸润淋巴细胞(TIL)的免疫刺激微环境,并上调预测对抗 PD1 治疗反应的炎症特征,而与基线相比,治疗结束时残留肿瘤的免疫抑制。NAC 引起的 TIL 和 CD8+T 细胞比例的增加与病理完全缓解独立相关。此外,尽管这些与治疗结果密切相关,但治疗期间的免疫反应比配对基线样本中的免疫特征更能预测治疗结果。